(a) Provide a table showing, with respect to the proposed chief executive officer of the subject institution and, in case the subject institution is to be a commercial bank with trust department, the proposed senior trust officer, and any other proposed officer of the subject institution who has been selected:

1. (1) Name.
2. (2) Business address.
3. (3) Home address.
4. (4) Age.
5. (5) Business or occupation.
6. (6) Amount of shares of the subject institution for which the proposed officer and his consociates intend to subscribe.
7. (7) Proposed title.
8. (8) Proposed duties.
9. (9) Proposed annual salary.

(b) Provide a table showing, with respect to each proposed officer position for which no person has been selected, including, in case the subject institution is to engage in commercial banking business, the positions of principal commercial lending officer and principal operations officer and, in case the subject institution is to engage in trust business, the positions of principal trust investment officer, principal trust operations officer, and trust administrative officers:

1. (1) Proposed title.
2. (2) Proposed duties.
3. (3) Proposed annual salary.

(c) With respect to each proposed officer of the subject institution listed in the table called for in Subdivision (a) of this Section, provide:

1. (1) Personal financial statement in the form of Department Form 2, containing the information called for therein, dated as of a date within 90 days before the filing of the application, and signed by the proposed officer.
2. (2) Confidential resume in the form of Department Form 3, containing the information called for therein, dated as of a date within 90 days before the filing of the application, and signed by the proposed officer.

3. (3) Statement dated as of a date within 90 days before the filing of the application and signed by the proposed officer, stating:

   1. (A) Amount of shares of the subject institution for which the proposed officer intends to subscribe, the source of funds with which he intends to pay for such subscription, and, if any of such funds are to be borrowed, the amount to be borrowed and the source of funds with which he intends to repay such amount.
   2. (B) Whether or not, to the knowledge or information and belief of the proposed officer, any consociate of the proposed officer intends to subscribe for shares of the subject institution and, if so, the name, business address, home address, and business or occupation of the consociate, the amount of shares of the subject institution for which the consociate intends to subscribe, the source of funds with which he intends to pay for such subscription, and, if any of such funds are to be borrowed, the amount to be borrowed and the source of funds with which he intends to repay such amount.
   3. (C) Commercial banking, trust, other financial, and other business experience of the proposed officer, including, with respect to each position held, title, description of duties, name and address of employer, period of employment, and reason for leaving.
   4. (D) Whether or not the proposed officer has had in the past or has presently any relationship with any bank as director, officer, employee, advisor, five percent equity security owner, or in any other capacity (other than solely as customer), and, if so, the name of the bank and a description of the relationship, and, in the case of any present relationship, whether the proposed officer intends to continue, change, or terminate such relationship if and when the subject institution commences business.
   5. (E) Whether or not the proposed officer has ever been discharged or requested to resign from any position, and, if so, an account of the circumstances.

(g) State whether or not the subject institution proposes to retain any adviser, and, if so, provide, with respect to each such adviser:

1. (1) Name.
2. (2) Name of firm of which the adviser is a member or by which the adviser is employed.
3. (3) Business address.
4. (4) Description of services which the adviser is to render to the subject institution.
5. (5) Summary of the adviser's professional qualifications relating to the services referred to in Paragraph (4) of this Subdivision (g).